Winged Scapula (Scapular Dyskinesis)

by Dr. Richard Bartholomew

What is a scapula?

A scapula also known as scapula bone, shoulder bone, shoulder blade, or wing bone is the bone that connects the humerus (upper arm bone) with the clavicle (collarbone).

winged scapula, dyskinesis photoWhat is Dyskinesis (Winged Scapula)?

Dyskinesis or Winged Scapula occurs from either a muscle imbalance in the shoulder blade area (scapular muscles) or from a nerve injury which controls those muscles. The rotator cuff muscles all attach onto the scapula and then send the tendons to the humeral head or the top of the arm bone. These tendons help to rotate the arm. If the scapula is winging, it will cause the rotator cuff muscles to work differently and cause them to get irritated. This can lead to rotator cuff tendon problems.  See my newsletter section on the rotator cuff tear.

How to fix winged scapula?

If the scapula is winging from muscle weakness, then the only way to treat the problem is with physical therapy directed to the specific muscle(s) which are dysfunctional. I must stress that rotator cuff strengthening exercises will not make your scapular muscles better.

Is there any surgery that can fix this problem?

Unless your scapular problem is from a nerve injury, no surgical procedure can be done to correct the winging. Physical Therapy is the only option, but as mentioned above, one has to have the right type of physical therapy and not just rotator cuff strengthening exercises (this is very important).

Can I wear a brace to make this better?

A brace can be prescribed to help get your muscles back in shape, but it will not correct the problem by itself.  The best thing is to go to therapy and do your exercises as instructed by your therapist.

Do you ever see any other shoulder problems associated with scapular winging?

Yes, many of the patients with rotator cuff tears and with shoulder instability have some scapular dyskinesis. It is crucial in these cases to treat not only the tear or the instability but also the scapula. In patients with lax ligaments who have shoulder instability, scapular dyskinesis can exacerbate the shoulder looseness. Scapular dyskinesis can also make rotator cuff problems worse.

Dr. Bartholomew, orthopedic shoulder surgeon in Michigan, specializes in the treatment of Dyskinesis. Call our office to schedule a consultation to diagnose your shoulder blade pain. Call Bone and Joint Specialists at (248) 673-0500 serving the residents of Oakland County, Southeast Michigan, Metro Detroit, Madison Heights, Warren, Wayne, Waterford Township, and Macomb, Michigan.

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